Adiponectin as an Independent Predictor of the Presence and Degree of Hepatic Steatosis in the Dallas Heart Study

Context: Previous small case-control studies have suggested an inverse relationship between adiponectin and hepatic steatosis, but whether this finding is independent of insulin sensitivity and other intraabdominal fat depots is unclear. Objectives and Main Outcome Measures: The objective of this study was to establish whether an independent relationship exists between serum adiponectin concentrations and liver fat. Design, Setting, and Patients: Adiponectin levels were compared with hepatic triglyceride content (HTGC) as assessed by proton magnetic resonance spectroscopy in 2215 participants from the Dallas Heart Study. Multivariate modeling was performed to control for the effects of intraabdominal fat, insulin sensitivity, and other baseline factors. Results: In unadjusted analysis, adiponectin levels displayed inverse correlations with the amount of intraabdominal fat and HTGC. After multivariate adjustment, including individual intraabdominal fat depots and homeostasis model assessment of insulin resistance, HTGC remained significantly associated with adiponectin levels (beta = - 1.46, P < 0.0001 for women; beta = - 1.81, P < 0.0001 for men). Race- and gender-specific models demonstrated that this association was consistent across groups, except for Hispanic men. The adjusted odds ratio for hepatic steatosis (HTGC > 5.5%) per 1-SD increase in adiponectin concentrations was 0.64 (95% confidence interval = 0.52-0.78) for women and 0.61 (95% confidence interval = 0.51-0.74) for men. Conclusion: Data from a large, multiethnic population-based cohort show adiponectin levels are inversely associated with hepatic steatosis even after controlling for measures of insulin sensitivity, extrahepatic abdominal adiposity, and ethnicity. The mechanistic underpinnings of this association warrant further exploration. (J Clin Endocrinol Metab 97: E982-E986, 2012)